Term
Juvenile Rheumatoid Arthritis (JRA) AKA Juvenile Idiopathic Arthritis (JIA)
1. What is it?
2. Characteristized by? |
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Definition
1. A chronic AUTOIMMUNE inflammatory disease causing inflammation of joints and other tissue with an UNKNOWN CAUSE
2. Characterized by CHRONIC INFLAMMATION of the synovium with joint effusion & eventual errosion, destruction, and fibrosis of the articular cartilage. Adhesions between joint surfaces and ankylosis of joints can occur |
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Term
JIA/JRA
1. Who gets it?
2. Age of peak onset? |
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Definition
1. Twice as many girls as boys are affected (Book reports incidence among caucasians but does not mention other races/ethnicities)
2. Peak onset between 1 and 3 years of age. It will always start before age 16 |
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Term
| Ultimate goal of treatment for JIA/JRA? |
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Definition
| Preserving function and Preventing deformity |
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Term
| What is an excellent form of physical therapy for children with JIA/JRA? Why? |
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Definition
| Exercising in a pool because it allows freedom of movement with support and minimal gravitational pull. |
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Term
| Common interventions for JIA/JRA? |
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Definition
1. Nighttime Splinting of Joints
2. Careful Positioning during Rest/Sleep
3. Child should sleep on firm mattress without pillows or a very low pillow. Additionally nothing should be under the knees. |
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Term
| 3 Common Pharmaceutical Therapies for JIA/JRA? |
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Definition
1. NSAIDS
2. Methotrexate
3. Corticosteroids
(Also Etanercept and SAARD's may be used but not as common as top 3) |
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Term
| 1. Most appropriate Nursing dx for children with JIA/JRA? 2. What would the interventions be? |
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Definition
1. PAIN
2. Non-pharm therapies such as behavioral therapy, relaxation techniques, moist heat, whirlpool baths, hot packs are used
*Opioid analgesics are typically avoided/not part of routine management for pain |
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Term
Acute Laryngitis
-Is it usually caused by a bacteria or a virus? |
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Definition
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Term
| What is the most common of the Croup Syndromes? |
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Definition
| LARYNGOTRACHEOBRONCHITIS or LTB |
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Term
| 5 manifestations of LTB (Laryngotracheobronchitis)? |
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Definition
1. Inspiratory Stridor
2. Supracostal Retractions
3. Barking or Seal-like cough
4. Increasing Respiratory Distress & Hypoxia
5. Can progress to Respiratory Acidosis, Resp. Failure & Death |
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Term
| How is LTB cared for? 4 interventions |
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Definition
1. Airway management
2. Maintain Hydration (PO/IV)
3. High humidity with cool mist
4. Nebulizer treatments of Epinephrine &/or Steroids |
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Term
| 7 S & S of Duchenne Muscular Dystrophy (DMD) |
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Definition
1. Relentless progression of muscular weakness, wasting and contractures
2. Calf Muscle Hypertrophy (hypertrophy can occur elsewhere also)
3. Loss of independent ambulation by 9-12 years of age
4. Lordosis
5. Waddling Gait
6. Frequent Falls
7. Gower Sign |
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Term
| A nurse should aid a child with DMD to be as ___________ as possible for as ________ as possible |
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Definition
| Independent for as Long as possible |
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Term
| What devices/interventions are used for respiratory care in children with advanced DMD? |
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Definition
1. Non-invasive ventilation with BiPaP
2. Mechanically assisted coughing (MAC) or Mechanical Cough Inexsufflator (MIE)
3. Coughing and Suctioning devices
4. Tracheotomy (although this has been associated with further complications)
5. Home pulse oximetry to monitor oxygenation during sleep |
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Term
| With Duchenne Muscular Dystrophy (DMD) what are the usual causes of death? Why? |
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Definition
Respiratory Tract Failure or Cardiac Failure.
This is because disease will progress to affect the diaphragm and auxillary muscles of respiration and affect cardiovascular function/structure. |
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Term
| What are the primary and secondary goals of treatment for children with DMD? |
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Definition
1. Primary - Maintain optimal function in all muscles for as long as possible.
2. Secondary - Prevention of contractures |
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Term
| What causes Duchenne & Becker Muscular Dystrophy? |
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Definition
| DMD and BMD result from mutations of the gene that codes DYSTROPHIN, a protein product in skeletal muscle. DYSTROPHIN will be absent in DMD & reduced/abnormal in BMD. |
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Term
| When do the S & S of DMD usually start to show in children? |
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Definition
| Muscle weakness usually appears during the 3rd to 7th year. The first symptoms noted are usually difficulties in running, riding a bike and climbing. |
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Term
| What is GOWER SIGN? What disorder is it associated with? |
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Definition
Gower sign is when a child will turn onto his/her side or abdomen, flex knees to assume a kneeling position, then with knees extended gradually push their torso to an upright position by "walking" their hands up their legs.
-It is associated with Duchenne Muscular Dystrophy |
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Term
| Who gets Duchenne Muscular Dystrophy (DMD)? Why? |
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Definition
| Boys - because it is an X-LINKED RECESSIVE trait |
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Term
| Sore Throat, Tripod Positioning, Retractions, Inspiratory Stridor, Mild Hypoxia, Pain, and Distress are all S & S for? |
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Definition
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Term
| Principle Cause of Infectious Mononucleosis? |
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Definition
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Term
| 1 gram of wet diaper equals how many mL of urine? |
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Definition
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Term
| Normal & Average pH of Urine |
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Definition
1. Normal for newborn: 5-7, thereafter: 4.8-7.8
2. Average: 6 |
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Term
| What is the calculation to determine bladder capacity in children? |
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Definition
| Age (years) + 2 = oz.'s of bladder capacity |
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Term
| Most common causative agent of UTI? |
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Definition
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Term
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Definition
| Inflammation of the Bladder |
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Term
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Definition
| Inflammation of the Upper Urinary Tract and Kidneys |
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Term
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Definition
| Febrile UTI coexisting with systemic signs of bacterial illness; blood culture reveals presence of urinary pathogen |
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Term
| A UTI accompanied with a FEVER, (aka FEBRILE UTI) usually indicates? |
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Definition
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Term
| Who has the highest prevalence of UTI's |
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Definition
| Uncircumcised male infants under 3 months of age. |
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Term
| VESICOURETERAL REFLUX is usually associated with? |
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Definition
| Recurrent Kidney Infections |
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Term
| 2 important nursing interventions that should be performed on children with GU dysfunction? |
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Definition
1. Intake & Output
2. Blood Pressure |
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Term
| There is a correlation between infants with Low Set Ears and _______ ______ anomalies |
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Definition
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Term
| The most useful clinical estimation of GFR? |
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Definition
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Term
| A _______ environment promotes wound healing |
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Definition
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Term
| Should you slather your newborn baby with sunscreen? |
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Definition
| No! Sunscreens are not recommended for infants younger than 6 months of age. You can apply to small areas of the skin but in general, just keep them out of direct sun |
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Term
| Important interventions to take when caring for a Burn Patient |
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Definition
1. Maintain adequate body temperature to avoid HYPOTHERMIA. (Avoid exposing large areas of the body simultaneously during dressing changes, Warmed solutions, linens, occlusive dressings, heat shields, radiant warmers may also be used)
2. Be vigilant for signs of INFECTION - infection is the chief danger during acute care - wound infection, sepsis and bacterial pneumonia.
3. Prevention of contractures/loss of function (they don't want to move due to the pain or fear of pain)
4. PAIN management |
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Term
| How are scars avoided on burn patients? |
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Definition
| With uniform pressure. Pressure will be applied to the areas of scarring with elastic bandages or pressure garments |
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Term
| Describe the appearance of a First Degree or Superficial Burn |
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Definition
| Dry Surface; red; BLANCHES on pressure and refills; minimal or no edema |
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Term
| Describe the appearance of Second Degree or Partial thickness burns |
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Definition
| Blistered; mosit; serous drainage; edema; mottled pink or red, reddened; BLANCHES on pressure and refills |
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Term
| Describe the appearance of Third Degree or Full-Thickness burns |
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Definition
| Tough; leathery; marbled, pale white, brown, tan, black, or red; does NOT BLANCH on pressure; dull, dry; edema |
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Term
| Describe the appearance of a Fourth Degree or Full-thickness burn? |
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Definition
| Appears dull and dry & ligaments, tendons and bone may be exposed; involves the underyling structures such as muscle, fascia, and bone. |
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Term
| Accutane is a drug for? Why does one have to be careful when taking this drug? |
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Definition
| Accutane is a medication for SEVERE cystic acne & usually only prescribed when other pharms have not worked. The drug can cause suicidal ideations in teens and is teratogenic to fetuses so pregnant women should absolutely not take it. |
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Term
| Nits (from Lice) that are shed into the environment are capable of hatching in ___ to ___ days. |
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Definition
| 7 to 10 days. This means that even after you've done the lice shampoo once you may have to retreat again. |
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Term
| PEDICULOSIS CAPITIS (What is this?) |
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Definition
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Term
| What skin disorder is caused when the "impregnated female burrows into the into the stratum corneum of the epidermis to deposit her EGGS and FECES"? |
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Definition
| Scabies, caused by the scabies mite, Sarcoptes scabiei |
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Term
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Definition
| Immediately flush the affected area with COLD running water, If in the hospital the nurse can clease with isopropyl alcohol followed by water |
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Term
| What is the safest solution for wound care? |
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Definition
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Term
| When should Growth Hormone be given? |
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Definition
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Term
| What is Diabetes Insipidus caused by? |
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Definition
| By posterior pituitary hypofunction, resulting in the undersecretion of ANTIDIURETIC HORMONE (ADH) or VASOPRESSIN; producing a state of uncontrolled diuresis |
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Term
| What are the cardinal signs of DI? |
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Definition
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Term
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Definition
| With AQUEOUS VASOPRESSIN (Hormone replacement) |
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Term
| Besides familial or idiopathic causes, what other events/conditions may result in Diabetes Insipidus? |
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Definition
Trauma (accidental or surgical)
Tumors
Granulomatous Disease
Infections (meningitis or encephalitis)
Vascular anomalies (aneurysm)
*Alcohol & Phenytoin can cause transient polyuria |
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Term
| If an infant is born with a GOITER what are the immediate interventions put in place? |
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Definition
| Immediate precautions for emergency ventilation, such as oxygen and trach set nearby. Hyperextension of the neck often facilitates breathing |
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Term
| What is the drug of choice to treat the central type of PRECOCIOUS PUBERTY? |
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Definition
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Term
| What hormone regulates the Basal Metabolic Rate? |
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Definition
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Term
What condition is manifested by:
Decelerated Growth
Myxedematous skin changes:
Dry skin
Sparse hair
Periorbital edema |
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Definition
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Term
| Most common cause of hyperthyroidism in childhood is? |
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Definition
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Term
| What 3 groups of STEROIDS does the ADRENAL CORTEX secrete? |
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Definition
1. Glucocorticoids (cortisol, corticosterone)
2. Mineralocorticoids (aldosterone)
3. Sex steroids (androgens, estrogens, progestins) |
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Term
| What syndrome is characterized by EXCESSIVE circulating free CORTISOL? |
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Definition
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Term
| Cushing Syndrome can be caused by? |
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Definition
| Excessive or Prolonged STEROID THERAPY (as in Asthma, etc.) |
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Term
| In a child with Hyperaldosteronism, the nurse should be alert for? |
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Definition
| Signs and symptoms of hypokalemia and hyperkalemia |
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